DYLAN MICHAEL LEBOURVEAU

WEST ISLIP, NY
NPI1700132255
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  303092)
Enumeration Date2012-08-01
Last Update Date2018-03-17
Business Address
DYLAN MICHAEL LEBOURVEAU L.P.N.
1145 MONTAUK HWY STE 1
WEST ISLIP, NY 11795-4909
Phone number: 631-666-0111
Mailing Address
DYLAN MICHAEL LEBOURVEAU L.P.N.
227 MAPLECREST DR
RONKONKOMA, NY 11779-1964
Phone number: 631-466-2457